Kentucky

Commonwealth of Kentucky
County of ________________


BEFORE ME, the undersigned Notary, ________ [name of Notary before whom affidavit is sworn], on this ___________  [day of month] day of _________________ [month], 20____, personally appeared __________ [name of affiant], known to me to be a credible person and of lawful age, who being by me first duly sworn, on ______ [his or her] oath, deposes and says:

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

[set forth affiant's statement of facts]


__________________________________
[signature of affiant]


__________________________________
[typed name of affiant]


__________________________________
[address of affiant, line 1]

__________________________________
[address of affiant, line 2]


Subscribed and sworn to before me, this ___________ [day of month] day of _____________ [month], 20__.

  [Notary Seal:]



__________________________________ 
[signature of Notary]
    
           
__________________________________ 
[typed name of Notary]

       NOTARY PUBLIC

       My commission expires: ________________, 20____.



Do you require an affidavit from another state? Click the appropriate link below:

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